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Author: Gregory O'Grady Publisher: Gregory O'Grady ISBN: Category : Languages : en Pages : 373
Book Description
Gastric motility disorders remain a complex clinical challenge, and inflict a substantial burden of cost and suffering on society. Gastric contractions are coordinated by an underlying electrical activity, and gastric dysrhythmias are implicated in the pathophysiology of several motility disorders. However, the significance of dysrhythmias remains uncertain, and there are few elective therapies, because current tools to investigate dysrhythmias have low reliability owing to their lack of spatial resolution. This thesis aimed to develop an improved foundation for the investigation and management of gastric dysrhythmia, by advancing and translating high-resolution (HR; multi-electrode) spatiotemporal mapping. The research is a cross-disciplinary program of bioengineering, and basic and clinical electrophysiology. A range of HR mapping devices are first developed and validated for intra-operative gastric mapping, including at open and laparoscopic surgery. Automated signal processing tools are next validated for the efficient, reliable marking, grouping, and mapping of slow wave events, and these tools are integrated into an intuitive software platform. These methodological advances are then applied in a series of experimental studies. The origin and propagation of porcine gastric slow wave activity is defined, followed by clinical translation with the first spatiotemporal analysis of normal human gastric slow wave propagation. The methods are then applied to define new patterns and mechanisms of gastric dysrhythmia, initially in a porcine model, including the first demonstration of how rapid, high-amplitude circumferential propagation emerges during dysrhythmias. The first clinical study applying HR electrical mapping is then presented, performed on a cohort of patients with diabetic and idiopathic gastroparesis, revealing new patterns of human dysrhythmia. A new classification scheme for abnormalities of human gastric slow wave initiation and conduction is proposed. Finally, the evidence for high-frequency gastric electrical stimulation is reviewed, prior to the presentation of a new 'entrainment mapping' method for better assessing gastric pacing protocols. In total, this work constitutes a coordinated series of advances that offer a strengthened foundation for investigating and managing gastric electrical abnormalities. It is hoped that these new methods and findings will translate into future clinical advances, to improve the diagnosis and treatment of these complex patient populations.
Author: Gregory O'Grady Publisher: Gregory O'Grady ISBN: Category : Languages : en Pages : 373
Book Description
Gastric motility disorders remain a complex clinical challenge, and inflict a substantial burden of cost and suffering on society. Gastric contractions are coordinated by an underlying electrical activity, and gastric dysrhythmias are implicated in the pathophysiology of several motility disorders. However, the significance of dysrhythmias remains uncertain, and there are few elective therapies, because current tools to investigate dysrhythmias have low reliability owing to their lack of spatial resolution. This thesis aimed to develop an improved foundation for the investigation and management of gastric dysrhythmia, by advancing and translating high-resolution (HR; multi-electrode) spatiotemporal mapping. The research is a cross-disciplinary program of bioengineering, and basic and clinical electrophysiology. A range of HR mapping devices are first developed and validated for intra-operative gastric mapping, including at open and laparoscopic surgery. Automated signal processing tools are next validated for the efficient, reliable marking, grouping, and mapping of slow wave events, and these tools are integrated into an intuitive software platform. These methodological advances are then applied in a series of experimental studies. The origin and propagation of porcine gastric slow wave activity is defined, followed by clinical translation with the first spatiotemporal analysis of normal human gastric slow wave propagation. The methods are then applied to define new patterns and mechanisms of gastric dysrhythmia, initially in a porcine model, including the first demonstration of how rapid, high-amplitude circumferential propagation emerges during dysrhythmias. The first clinical study applying HR electrical mapping is then presented, performed on a cohort of patients with diabetic and idiopathic gastroparesis, revealing new patterns of human dysrhythmia. A new classification scheme for abnormalities of human gastric slow wave initiation and conduction is proposed. Finally, the evidence for high-frequency gastric electrical stimulation is reviewed, prior to the presentation of a new 'entrainment mapping' method for better assessing gastric pacing protocols. In total, this work constitutes a coordinated series of advances that offer a strengthened foundation for investigating and managing gastric electrical abnormalities. It is hoped that these new methods and findings will translate into future clinical advances, to improve the diagnosis and treatment of these complex patient populations.
Author: National Research Council Publisher: National Academies Press ISBN: 0309142393 Category : Law Languages : en Pages : 348
Book Description
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.
Author: John A. Kellum Publisher: Oxford University Press ISBN: 019022553X Category : Medical Languages : en Pages : 329
Book Description
Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance for the management of critically ill patients with acute renal failure, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice.
Author: K. Ray Chaudhuri Publisher: Oxford University Press, USA ISBN: 0199684243 Category : Medical Languages : en Pages : 517
Book Description
Patients with Parkinson's disease (PD) are known to suffer from motor symptoms of the disease, but they also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment have been developed and are readily available. In contrast, researchers have only recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated by clinicians. The NMS of PD have a significant impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. While some NMS can be improved with currently available treatments, others may be more refractory and will require research into novel (non-dopaminergic) drug therapies for the future. Edited by members of the UK Parkinson's Disease Non-Motor Group (PD-NMG) and with contributions from international experts, this new edition summarizes the current understanding of NMS symptoms in Parkinson's disease and points the way towards future research.
Author: National Research Council Publisher: National Academies Press ISBN: 0309039940 Category : Medical Languages : en Pages : 765
Book Description
Diet and Health examines the many complex issues concerning diet and its role in increasing or decreasing the risk of chronic disease. It proposes dietary recommendations for reducing the risk of the major diseases and causes of death today: atherosclerotic cardiovascular diseases (including heart attack and stroke), cancer, high blood pressure, obesity, osteoporosis, diabetes mellitus, liver disease, and dental caries.
Author: J.W.G. Jacobs Publisher: IOS Press ISBN: 1614998787 Category : Medical Languages : en Pages : 370
Book Description
Generalized hypermobility has been known since ancient times, and a clinical description of Ehlers-Danlos syndrome (EDS) is said to have first been recorded by Hippocrates in 400 BC. Hypermobility syndromes occur frequently, but the wide spectrum of possible symptoms, coupled with a relative lack of awareness and recognition, are the reason that they are frequently not recognized, or remain undiagnosed. This book is an international, multidisciplinary guide to hypermobility syndromes, and EDS in particular. It aims to create better awareness of hypermobility syndromes among health professionals, including medical specialists, and to be a guide to the management of such syndromes for patients and practitioners. It is intended for use in daily clinical practice rather than as a reference book for research or the latest developments, and has been written to be understandable for any healthcare worker or educated patient without compromise to the scientific content. The book is organized as follows: chapters on classifications and genetics are followed by chapters on individual types, organ (system) manifestations and complications, and finally ethics and therapeutic strategies, with an appendix on surgery and the precautions which should attend it. A special effort has been made to take account of the perspective of the patient; two of the editors have EDS. The book will be of interest to patients with hypermobility syndromes and their families, as well as to all those healthcare practitioners who may encounter such syndromes in the course of their work.
Author: Charles Antzelevitch Publisher: Springer ISBN: 3319315781 Category : Medical Languages : en Pages : 342
Book Description
This book delineates the state of the art of the diagnosis and treatment of J wave syndromes, as well as where future research needs to be directed. It covers basic science, translational and clinical aspects of these syndromes. The authors are leading experts in their respective fields, who have contributed prominently to the literature concerning these topics. J wave syndromes are one of the hottest topics in cardiology today. Cardiac arrhythmias associated with Brugada syndrome (BrS) or an early repolarization (ER) pattern in the inferior or infero-lateral ECG leads are thought to be mechanistically linked to accentuation of transient outward current (Ito)-mediated J waves. Although BrS and ER syndrome (ERS) differ with respect to magnitude and lead location of abnormal J waves, they are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. ERS is divided into three subtypes with the most severe, Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads. BrS has been linked to mutations in 19 different genes, whereas ERS has been associated with mutations in 7 different genes. There is a great deal of confusion as to how to properly diagnose and treat the J wave syndromes as well as confusion about the underlying mechanisms. The demonstration of successful epicardial ablation of BrS has provided new therapeutic options for the management of this syndrome for which treatment alternatives are currently very limited, particularly in the case of electrical storms caused by otherwise uncontrollable recurrent VT/VF. An early repolarization pattern is observed in 2-5% of the US population. While it is clear that the vast majority of individuals exhibiting an ER pattern are not at risk for sudden cardiac death, the challenge moving forward is to identify those individuals who truly are at risk and to design safe and effective treatments.
Author: Roger W. Byard Publisher: ISBN: 9781925261677 Category : Medical Languages : en Pages : 844
Book Description
This volume covers aspects of sudden infant and early childhood death, ranging from issues with parental grief, to the most recent theories of brainstem neurotransmitters. It also deals with the changes that have occurred over time with the definitions of SIDS (sudden infant death syndrome), SUDI (sudden unexpected death in infancy) and SUDIC (sudden unexpected death in childhood). The text will be indispensable for SIDS researchers, SIDS organisations, paediatric pathologists, forensic pathologists, paediatricians and families, in addition to residents in training programs that involve paediatrics. It will also be of use to other physicians, lawyers and law enforcement officials who deal with these cases, and should be a useful addition to all medical examiner/forensic, paediatric and pathology departments, hospital and university libraries on a global scale. Given the marked changes that have occurred in the epidemiology and understanding of SIDS and sudden death in the very young over the past decade, a text such as this is very timely and is also urgently needed.
Author: National Research Council Publisher: National Academies Press ISBN: 0309051266 Category : Science Languages : en Pages : 188
Book Description
In the years since the third edition of this indispensable reference was published, a great deal has been learned about the nutritional requirements of common laboratory species: rat, mouse, guinea pig, hamster, gerbil, and vole. The Fourth Revised Edition presents the current expert understanding of the lipid, carbohydrate, protein, mineral, vitamin, and other nutritional needs of these animals. The extensive use of tables provides easy access to a wealth of comprehensive data and resource information. The volume also provides an expanded background discussion of general dietary considerations. In addition to a more user-friendly organization, new features in this edition include: A significantly expanded section on dietary requirements for rats, reporting substantial new findings. A new section on nutrients that are not required but that may produce beneficial results. New information on growth and reproductive performance among the most commonly used strains of rats and mice and on several hamster species. An expanded discussion of diet formulation and preparationâ€"including sample diets of both purified and natural ingredients. New information on mineral deficiency and toxicity, including warning signs. This authoritative resource will be important to researchers, laboratory technicians, and manufacturers of laboratory animal feed.
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Author: Gregory O'Grady
Author: National Research Council
Author: John A. Kellum
Author: K. Ray Chaudhuri
Author: National Research Council
Author: United States. Public Health Service. Office of the Surgeon General
Author: J.W.G. Jacobs
Author: Charles Antzelevitch
Author: Roger W. Byard
Author: National Research Council